分階段綜合護理干預(yù)對妊娠期糖尿病預(yù)后的影響

林翠紅　崔嫦婷　蔡佩芝　袁雪蓉

【摘要】 目的：探討分階段綜合護理干預(yù)對妊娠期糖尿病（GDM）預(yù)后的影響。方法：選取2015年4月-2017年1月本院收治GDM患者120例，以不同護理方式分為觀察組和對照組，每組60例。觀察組給予分階段綜合護理干預(yù)，對照組給予常規(guī)護理干預(yù)。觀察兩組基線期及干預(yù)后的血清FPG、2 h PG及GHbA1c水平變化，并跟蹤兩組妊娠母嬰結(jié)局。結(jié)果：干預(yù)后，觀察組血清FPG、2 h PG、GHbA1c均顯著低于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）；觀察組妊娠期并發(fā)癥發(fā)生率、剖宮產(chǎn)率均顯著低于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）；觀察組新生兒窒息、新生兒低血糖、高膽紅素血癥的發(fā)病率均顯著低于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）；觀察組Apgar評分顯著高于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論：分階段綜合護理干預(yù)GDM，可改善妊娠期指標(biāo)，改善妊娠母嬰結(jié)局。

【關(guān)鍵詞】 GDM； 綜合護理； 不同階段； 妊娠母嬰結(jié)局

Influence of Various Stages Comprehensive Nursing Intervention on Pregnant Prognosis of Gestational Diabetes Mellitus/LIN Cui-hong，CUI Chang-ting，CAI Pei-zhi，et al.//Medical Innovation of China，2017，14（22）：088-090

【Abstract】 Objective：To discussing the influence of various stages comprehensive nursing intervention on pregnant prognosis of gestational diabetes mellitus（GDM）.Method：A total of 120 patients with GDM were selected from April 2015 to January 2017 in our hospital，according to different forms of care they were divided into the observation group and the control group，60 cases in each group.The observation group was given various stages comprehensive nursing，the control group was given routine nursing.Serum levels of fasting blood-glucose（FPG），2-hour postprandial blood glucose（2 h PG） and glycosylated hemoglobin（GHbA1c）of two groups were observed at baseline and after intervention，and the maternal and fetal outcomes of two groups were followed-up.

Result：After intervention，serum levels of GLU，2 h PG and GHbA1c of the observation group were lower than those of the control group，the differences were statistically significant（P<0.05）；incidences of pregnancy complication，caesarean section of the observation group were lower than those of the control group，the differences were statistically significant（P<0.05）；incidence rates of asphyxia neonatorum，neonatal hypoglycemia and hyperbilirubinemia of the observation group were lower than those of the control group，the differences were statistically significant（P<0.05）.Apgar score of the observation group was higher than that of the control group，the difference were statistically significant（P<0.05）.Conclusion：The stage of comprehensive nursing intervention in the period of gestational diabetes can improve the index of pregnancy and the outcome of pregnancy.

【Key words】 Gestational diabetes mellitus； Comprehensive nursing； Various stages； Maternal and fetal outcomes

First-authors address：No.1 Maternal and Child Health Hospital of Huizhou City，Huizhou 516000，Chinaendprint

doi：10.3969/j.issn.1674-4985.2017.22.025

流行病學(xué)研究指出，因人們生活水平的不斷提高，孕婦普遍存在營養(yǎng)過剩的現(xiàn)象，而孕婦普遍缺乏妊娠健康知識，故我國妊娠期糖尿病（GDM）發(fā)病率呈持續(xù)上升趨勢[1]。妊娠母嬰結(jié)局取決于GDM的病情嚴重程度[2-3]。因此，本院為提高護理服務(wù)質(zhì)量、改善患者預(yù)后，開展分階段綜合護理干預(yù)對GDM預(yù)后的影響研究，現(xiàn)報道如下。

1 資料與方法

1.1 一般資料 選取2015年4月-2017年1月本院收治GDM患者120例，以不同護理方式分為觀察組和對照組，每組60例。根據(jù)《婦產(chǎn)科學(xué)》GDM的相關(guān)診斷標(biāo)準(zhǔn)[4]，經(jīng)診斷所有病例均確診為GDM。觀察組年齡22～33歲，平均（27.46±4.26）歲；孕周24～39周，平均（34.11±4.74）周；體重47～69 kg，平均（62.00±6.12）kg；初產(chǎn)婦51例，經(jīng)產(chǎn)婦9例。對照組年齡22～34歲，平均（27.34±4.45）歲；孕周24～39周，平均（34.42±4.17）周；體重49～70 kg，平均（62.00±6.45）kg；初產(chǎn)婦50例，經(jīng)產(chǎn)婦10例。兩組性別、年齡、孕周、產(chǎn)史、體重等一般資料比較差異均無統(tǒng)計學(xué)意義（P>0.05），具有可比性。

1.2 納入與排除標(biāo)準(zhǔn) 納入標(biāo)準(zhǔn)：（1）GDM；（2）單胎妊娠；（3）知情且簽署知情同意書。排除標(biāo)準(zhǔn)：（1）NT增厚；（2）多次流產(chǎn)史、習(xí)慣性流產(chǎn)、瘢痕子宮等其他產(chǎn)科并發(fā)癥者；（……